Individual
CAROLINE TRACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
US 191 & AZ 264, GANADO, AZ 86505
(928) 755-4933
(928) 755-4831
Mailing address
US 191 & AZ 264, BOX 457, GANADO, AZ 86505-0457
(928) 755-4632
(928) 755-4831
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP3896
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3451
—
NM
Enumeration date
04/02/2008
Last updated
05/28/2025
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